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Last week CBO released its latest report on the outlook for the budget and the economy; we also released a companion report that takes a closer look at the slow recovery of the labor market. The budget and economic projections presented in those reports include an updated analysis of the effects of the Affordable Care Act (ACA) on labor markets, which we explain in Appendix C of the report on the outlook. That analysis has attracted a great deal of attention and raised several questions. In this blog posting, we try to answer a few of the questions we have been asked.

Q: Will 2.5 Million People Lose Their Jobs in 2024 Because of the ACA?

A: No, we would not describe our estimates in that way.

We wrote in the report: “CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor.” The reason for the reduction in the supply of labor is that the provisions of the ACA reduce the incentive to work for certain subsets of the population.

For example, under the ACA, health insurance subsidies are provided to some people with low income and are phased out as their income rises; as a result, a portion of the added income from working more would be offset by a loss of some or all of the subsidies, which represents an implicit tax on earnings. Also, the ACA’s subsidies effectively boost the income of recipients, which will lead some of them to decide they can work less and still maintain or improve their standard of living. Therefore, some people will decide not to work or to work fewer hours than would otherwise be the case—including some people who will choose to retire earlier than they would have otherwise, and some people who will work less themselves and rely more on a spouse’s earnings. (Many other factors influence decisions about working, including, for example, income and payroll taxes and the cost of commuting and child care. Moreover, under current economic conditions, a substantial number of people who would like to work cannot find a job.)

Because the longer-term reduction in work is expected to come almost entirely from a decline in the amount of labor that workers choose to supply in response to the changes in their incentives, we do not think it is accurate to say that the reduction stems from people “losing” their jobs.

Here’s a useful way to think about the choice of wording: When firms do not have enough business and decide to lay people off, the people who are laid off are generally worse off and are therefore unhappy about what is happening. As a result, other people express their sympathy to those people for having “lost their jobs” due to forces beyond their control. In contrast, when the labor market is strong and people decide on their own to retire, to leave work to take care of their families, or to cut back on their hours to pursue other interests, those people presumably think they are better off (or they would not be making the voluntary choices they are making). As a result, other people are generally happy for them and do not describe them as having “lost their jobs.”

Thus, there is a critical difference between, on the one hand, people who leave a job for reasons beyond their control and, on the other hand, people who choose not to work or to work less. The wording that people use to describe those differing circumstances reflects the different reactions of the people involved. In our report, we indicated that “the estimated reduction [in employment] stems almost entirely from a net decline in the amount of labor that workers choose to supply,” so we think the language of “losing a job” does not fit.

Ultimately, we project that the number of jobs in the economy will be smaller than it would be in the absence of the ACA because some people will choose not to work at all, but CBO did not estimate the size of that change separately from the effect of people choosing to work fewer hours. We wrote in the report: “The reduction in CBO’s projections of hours worked represents a decline in the number of full-time-equivalent workers of about 2.0 million in 2017, rising to about 2.5 million in 2024 … The decline in full-time-equivalent employment stemming from the ACA will consist of some people not being employed at all and other people working fewer hours; however, CBO has not tried to quantify those two components of the overall effect.” To be clear, total employment and hours worked will increase over the coming decade, but by less than they would have in the absence of the ACA. In the next few years, as we wrote in the report, the ACA “also will affect employers’ demand for workers, … both by increasing labor costs through the employer penalty (which will reduce labor demand) and by boosting overall demand for goods and services (which will increase labor demand).”

There is a broader question as to whether the society and the economy will be better off as a result of those choices being made available. Even though the individuals making decisions to work less presumably feel that they will be happier as a result of those decisions, total employment, investment, output, and tax revenue will be smaller. (Those effects are included in CBO’s budget and economic projections under current law.) To be sure, the health insurance system in place prior to the ACA generated its own distortions to people’s work decisions, but many of the decisions to work less under the ACA will be made possible by government-funded subsidies, the burden of which will be borne largely by other people. Moreover, people’s decisions about work are also affected by taxes and benefit programs apart from those related to health insurance. Hence, whether voluntary reductions in hours worked owing to the ACA are good or bad for the country as a whole is a matter of judgment.

A tradeoff of this sort—although not necessarily of the same magnitude—is intrinsic in any effort to significantly increase health insurance coverage or to provide other types of benefits that are aimed at low-income people. As we wrote in the report: “Subsidies that help lower-income people purchase an expensive product like health insurance must be relatively large to encourage a significant proportion of eligible people to enroll. If those subsidies are phased out with rising income …, the phaseout effectively … discourage[es] work.” Again, the best way to address that tradeoff is a matter of judgment. http://www.cbo.gov/publication/45096

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